国际医学寄生虫病杂志
國際醫學寄生蟲病雜誌
국제의학기생충병잡지
INTERNATIONAL JOURNAL OF MEDICAL PARASITIC DISEASES
2014年
6期
347-351
,共5页
胡合华%鲍子平%贺民%张华明%刘雄%张瑕%刘军%肖传云%王加松
鬍閤華%鮑子平%賀民%張華明%劉雄%張瑕%劉軍%肖傳雲%王加鬆
호합화%포자평%하민%장화명%류웅%장하%류군%초전운%왕가송
血吸虫病%防治%服务%均等化
血吸蟲病%防治%服務%均等化
혈흡충병%방치%복무%균등화
Schistosomiasis%Control and prevention%Service%Equality
目的 通过对两类血吸虫病防治(简称血防)服务实施者的工作效果进行探讨,为推动血防工作纳入公共卫生服务均等化提供科学依据. 方法 在湖北省江陵县选择血吸虫病疫情相仿的虾湖村和万场村,分别按县级血防机构为模式一和乡(镇)卫生院为模式二的血防服务实施主体,采用观察法比较两种血防服务实施主体查灭螺、查治病等服务工时;采取小组访谈方法了解该县所有血吸虫病流行村卫生人员的血防服务内容和意愿;采用优劣势分析法(strengths weakness opportunity threats,SWOT)对上述结果进行分析. 结果 江陵县虾湖村和万场村的常住人口分别为571人和618人,2011年人群推算感染率分别为1.72％和2.01％,两村的血吸虫病疫情相仿.在模式一情况下,每百名居民所需投入血检服务工时为2.57;每百名居民所需投入治疗服务工时为2.67;每百名居民所需投入粪检服务工时为11.94;每百名居民所需投入健康教育服务工时为2.49.在模式二情况下,每百名居民所需投入血检服务工时为2.82;每百名居民所需投入治疗服务工时为3.13;无技术力量开展粪检和查灭螺工作;每百名居民所需投入健康教育服务工时为17.78.对全县10所乡(镇)卫生院、88个村卫生室的负责人员进行访谈,共有90名乡(镇)卫生院院长及村卫生室负责人参加访谈,其中29人参与血防查病现场采样;41人参与对血检阳性患者的治疗;48人参与血防健康教育;无人参与血防查、灭螺工作.县级血吸虫病防治机构具有整体的综合防治观念,熟知综合防治知识和技能,以及血吸虫病检查等专项技术,但是无法实时了解居民的疫水接触等不卫生行为,而且,在短期内收集全体居民的血样和粪样困难很大.在实施基本公共卫生服务均等化的工作中,乡(镇)卫生院和村卫生室为村民建立了个人健康档案,可为慢性和晚期血吸虫病患者提供临床医疗服务,可及时与每位村民联系采集血样和粪样等查病工作,但是,防治血吸虫病的现场工作强度大,而且补贴低,因此,乡(镇)卫生院和村卫生室没有承担钉螺调查和消灭,以及血清学和病原学检查的工作的技能. 结论 在血吸虫病流行区,应将各项防治血吸虫病措施纳入基本公共卫生服务均等化体系.分别由县级血防机构、乡(镇)卫生院和村卫生室实施,保障居民获得最基本、最有效的基本公共卫生服务的目标.
目的 通過對兩類血吸蟲病防治(簡稱血防)服務實施者的工作效果進行探討,為推動血防工作納入公共衛生服務均等化提供科學依據. 方法 在湖北省江陵縣選擇血吸蟲病疫情相倣的蝦湖村和萬場村,分彆按縣級血防機構為模式一和鄉(鎮)衛生院為模式二的血防服務實施主體,採用觀察法比較兩種血防服務實施主體查滅螺、查治病等服務工時;採取小組訪談方法瞭解該縣所有血吸蟲病流行村衛生人員的血防服務內容和意願;採用優劣勢分析法(strengths weakness opportunity threats,SWOT)對上述結果進行分析. 結果 江陵縣蝦湖村和萬場村的常住人口分彆為571人和618人,2011年人群推算感染率分彆為1.72％和2.01％,兩村的血吸蟲病疫情相倣.在模式一情況下,每百名居民所需投入血檢服務工時為2.57;每百名居民所需投入治療服務工時為2.67;每百名居民所需投入糞檢服務工時為11.94;每百名居民所需投入健康教育服務工時為2.49.在模式二情況下,每百名居民所需投入血檢服務工時為2.82;每百名居民所需投入治療服務工時為3.13;無技術力量開展糞檢和查滅螺工作;每百名居民所需投入健康教育服務工時為17.78.對全縣10所鄉(鎮)衛生院、88箇村衛生室的負責人員進行訪談,共有90名鄉(鎮)衛生院院長及村衛生室負責人參加訪談,其中29人參與血防查病現場採樣;41人參與對血檢暘性患者的治療;48人參與血防健康教育;無人參與血防查、滅螺工作.縣級血吸蟲病防治機構具有整體的綜閤防治觀唸,熟知綜閤防治知識和技能,以及血吸蟲病檢查等專項技術,但是無法實時瞭解居民的疫水接觸等不衛生行為,而且,在短期內收集全體居民的血樣和糞樣睏難很大.在實施基本公共衛生服務均等化的工作中,鄉(鎮)衛生院和村衛生室為村民建立瞭箇人健康檔案,可為慢性和晚期血吸蟲病患者提供臨床醫療服務,可及時與每位村民聯繫採集血樣和糞樣等查病工作,但是,防治血吸蟲病的現場工作彊度大,而且補貼低,因此,鄉(鎮)衛生院和村衛生室沒有承擔釘螺調查和消滅,以及血清學和病原學檢查的工作的技能. 結論 在血吸蟲病流行區,應將各項防治血吸蟲病措施納入基本公共衛生服務均等化體繫.分彆由縣級血防機構、鄉(鎮)衛生院和村衛生室實施,保障居民穫得最基本、最有效的基本公共衛生服務的目標.
목적 통과대량류혈흡충병방치(간칭혈방)복무실시자적공작효과진행탐토,위추동혈방공작납입공공위생복무균등화제공과학의거. 방법 재호북성강릉현선택혈흡충병역정상방적하호촌화만장촌,분별안현급혈방궤구위모식일화향(진)위생원위모식이적혈방복무실시주체,채용관찰법비교량충혈방복무실시주체사멸라、사치병등복무공시;채취소조방담방법료해해현소유혈흡충병류행촌위생인원적혈방복무내용화의원;채용우열세분석법(strengths weakness opportunity threats,SWOT)대상술결과진행분석. 결과 강릉현하호촌화만장촌적상주인구분별위571인화618인,2011년인군추산감염솔분별위1.72％화2.01％,량촌적혈흡충병역정상방.재모식일정황하,매백명거민소수투입혈검복무공시위2.57;매백명거민소수투입치료복무공시위2.67;매백명거민소수투입분검복무공시위11.94;매백명거민소수투입건강교육복무공시위2.49.재모식이정황하,매백명거민소수투입혈검복무공시위2.82;매백명거민소수투입치료복무공시위3.13;무기술역량개전분검화사멸라공작;매백명거민소수투입건강교육복무공시위17.78.대전현10소향(진)위생원、88개촌위생실적부책인원진행방담,공유90명향(진)위생원원장급촌위생실부책인삼가방담,기중29인삼여혈방사병현장채양;41인삼여대혈검양성환자적치료;48인삼여혈방건강교육;무인삼여혈방사、멸라공작.현급혈흡충병방치궤구구유정체적종합방치관념,숙지종합방치지식화기능,이급혈흡충병검사등전항기술,단시무법실시료해거민적역수접촉등불위생행위,이차,재단기내수집전체거민적혈양화분양곤난흔대.재실시기본공공위생복무균등화적공작중,향(진)위생원화촌위생실위촌민건립료개인건강당안,가위만성화만기혈흡충병환자제공림상의료복무,가급시여매위촌민련계채집혈양화분양등사병공작,단시,방치혈흡충병적현장공작강도대,이차보첩저,인차,향(진)위생원화촌위생실몰유승담정라조사화소멸,이급혈청학화병원학검사적공작적기능. 결론 재혈흡충병류행구,응장각항방치혈흡충병조시납입기본공공위생복무균등화체계.분별유현급혈방궤구、향(진)위생원화촌위생실실시,보장거민획득최기본、최유효적기본공공위생복무적목표.
Objective To evaluate the effects of schistosomiasis control service by 2 sorts of implementer for the purpose of bringing schistosomiasis control into the content of equality of public health services.Methods Xiahu and Wanchang villages with similar schistosomiasis endemic situation in Jiangling County were selected as study sites.The implementers were county level of schistosomiasis control as model 1,township health center and village clinic as model 2.The working hours of snail survey and control,disease examination,and treatment were compared by observation method between 2 sorts of implementers.The village clinic staff was interviewed on schistosomiasis control and willingness by focus groups interview.The above data was analysized by strengths weakness opportunity threats (SWOT).Results The residents Xiahu and Wanchang villages were 571 and 618,the calculated human infection rates were 1.72％ and 2.01％,the schistosomiasis endemic situation was similar.In model 1,the working hours of schistosomiasis examination was 2.57,the working hours of treatment was 2.67,the working hours of stool examination was 11.94,the working hours of health education was 2.49.In model 2,the working hours of schistosomiasis examination was 2.82,the working hours of treatment was 3.13,the working hours of health education was 17.78,without ability for stool examination,snail survey and control.90 staff from 10 township health centers and 88 village clinics was interviewed.Among them,29 staff participated in schistosomiasis examination,41 staff participated in treatment,48 staff participated in health education.No staff participated in snail survey and control.The professional of county agency of schistosomiasis control had overall concept of comprehensive control,mastered the knowledge of schistosomiasis control and technique of examination,but had the difficulty for human blood and fecal samples collection in short time and controlling the unhealthy behavior of water contact in real time.Upon the equality of public health services,the individual health records were established by township health center and village clinic,they had rich clinical experience and offered service for chronic and advanced schistosomiasis patients.The village clinic professional could help blood and fecal samples collections.But township health center and village clinic were of inability for snail survey and control as well as examination on pathogens and blood samples.Conclusion For the sake of achievement of people acquiring equality of public health services,the measures of schistosomiasis prevention and control should be incorporated into public health services.The prevention and control activities should be implemented by county schistosomiasis control agencies,township health centers and village clinics.
